Individual
VITHIDA SUEBLINVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
840 S WOOD ST, M/C 856, CHICAGO, IL 60612-4325
(312) 996-6605
(312) 413-3373
Mailing address
840 S WOOD ST, M/C 856, CHICAGO, IL 60612-4325
(312) 996-6605
(312) 413-3373
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
36099389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36099389
—
IL
05
—
K09585
—
IL
Enumeration date
02/15/2006
Last updated
12/07/2011
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